Provider Demographics
NPI:1174320220
Name:ELMI, HASSAN A
Entity type:Individual
Prefix:
First Name:HASSAN
Middle Name:A
Last Name:ELMI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3955 156TH ST SMOKEY POINT BEHAVIOR HOSPITAL
Mailing Address - Street 2:
Mailing Address - City:MARYSVILLE
Mailing Address - State:WA
Mailing Address - Zip Code:98271
Mailing Address - Country:US
Mailing Address - Phone:360-651-6400
Mailing Address - Fax:
Practice Address - Street 1:3955 156TH ST SMOKEY POINT BEHAVIOR HOSPITAL
Practice Address - Street 2:
Practice Address - City:MARYSVILLE
Practice Address - State:WA
Practice Address - Zip Code:98271-9827
Practice Address - Country:US
Practice Address - Phone:206-293-9377
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-26
Last Update Date:2025-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP61665441363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health